Program/Event Name:

Program/Event Date:

Preferred tour departure time:    If applicable.

First Name:

Last Name:

Email Address:
 

How many total adults?              Children?  

Phone Number:

 $5.00/adult

Method of Payment  (please check one):
I am mailing a check made payable to: Heritage Trail Association.
I am bringing check/cash payment on event day (some events must be prepaid)
I will pay by credit card or PayPal.

How did you hear about this event (please check)?
Newsletter
Local Media
Website
Other, please explain: